Currently, the recommended second-line eradication regimen for Helicobacter pylori is a quadruple therapy consisting of PPI, bismuth, tetracycline and metronidazole. Recently, levofloxacin-based (PPI, levofloxacin and amoxicillin) and moxifloxacin-based (PPI, moxifloxacin and amoxicillin) triple therapy represent promising alternative. In Japan, PPI-based triple therapy (PPI, amoxicillin and metronidazole) is used for second-line regimen after failure of first-line eradication. The rate of second-line eradication is still high(approximately 90% (ITT)) and triple therapy with PPI, AMPC, and MNZ may still be considered useful for second-line eradication therapy of Helicobacter pylori in Japan. High-dose dual therapy with PPI and amoxicillin for 2 weeks may be useful treatment strategy after failure of first-line eradication.